【摘要】 目的　分析深圳地区近2年胆汁中微生物学分类及药敏状况,总结有效的经验用药方案,指导胆道外科合理应用抗生素。方法　对131例胆汁标本进行细菌、真菌培养、鉴定及药物敏感性试验,分析胆汁微生物学分布及药物敏感率特点。结果　131例阳性胆汁标本中共培养出 36 种 173 株细菌,6 种真菌共 47 株;本组病例中有45例呈现混合细菌或真菌感染(34.35%);细菌培养阳性率由高到低排列:肠球菌属、大肠埃希菌、葡萄球菌属、铜绿假单胞菌、克雷伯菌属、嗜麦芽寡养单胞菌、链球菌属、变形菌属、弗氏柠檬酸杆菌、鲍氏不动杆菌、少动鞘胺醇单胞菌、嗜水气单胞菌;真菌培养阳性率由高到低排列:白色念珠菌、热带念珠菌、近平滑念珠菌、光滑念珠菌、葡萄牙念珠菌、季也蒙念珠菌;对本地区胆汁细菌均具理想敏感率的抗生素是阿米卡星和哌拉西林/他唑巴坦;常见真菌对5 氟胞嘧啶、两性霉素和制霉菌素的敏感率为95.7%~100%。结论　深圳地区胆汁微生物学分布具有混合感染率高、常用抗生素敏感率低的特点,对该地区胆道细菌感染推荐选用阿米卡星和哌拉西林/他唑巴坦,真菌感染推荐选用5 氟胞嘧啶、两性霉素或制霉菌素。更多还原

【Abstract】 OBJECTIVE To investigate the microbiology and antibiotics sensitivity of bile in patients with infection of biliary tract of Shenzhen area recent years, and search for the most effective empiric antibiotic selection so as to apply antibiotics reasonablly. METHODS One hundred and thirty one cases of bile cultures collected during ERCP or operation from Jan 2002 to Jan 2004 were identified for bacteria and fungi, and the features of their antibiotics sensitivity were analyzed. RESULTS One hundred seventy three strains of bacteria belonged to thirty six species and forty seven strains of fungi belonged to six species were cultured from 131 positive samples, the frequency of polymicrobial infections was 34.35%. The arrangement of the bacteria species according to the rate of cultured positive was Enterococcus, Escherichia coli, Staphylococcus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Stenotrophomonas maltophilia, Streptococcus, Bacillus proteus, Citrobacter, Acinetobacter baumannii, Sphin gomonas paucimobilis, and Aeromonas hydrophila in order. The arrangement of the fungus species according to the rate of positive culture was Candida albicans, C. tropicalis, C. parapsilosis, C. glabrata, C. lucitaniae, and C. guilliermondii. Amikacin and piperacillin/tazobactam were of high sensitivity for the most bacteria, and 5 flucytosine, amphotericin or fungicidin were found possessing the sensitivity to common fungus as high as 95 7 100%. CONCLUSIONS The microbiology and antibiotics sensitivity of bile in patients with infection of biliary tract of Shenzhen area are characterized by high rate of polymicrobial infections and low sensitivity of common antibiotics. Use of amikacin and piperacillin/tazobactam for bacteria, and 5 flucytosine, amphotericin or fungicidin for fungus is recommended.更多还原